Sitting around a giant oval table in a conference room on the first floor of a downtown Anchorage office building, public guardian Ezra Stone talked to Sasha, one of the people he represents.
“(Are) there any hobbies or anything you want to try out this year, anything you want to do?” Stone asked.
“I want to try to do horse riding this summer,” Sasha said.
Sasha is 28 and has developmental disabilities and mental illness. We’re just using Sasha’s first name to protect his privacy.
He’s had an appointed guardian for 10 years, since his family raised concerns when he spent most of his Permanent Fund Dividend in one day on clothing.
Stone manages Sasha’s finances and benefits, and gives him an allowance to spend. Sasha is one of about 100 cases Stone is working with right now. That’s two to three times the caseload cap recommended by experts in the field.
Guardians like Stone are employed by the state and work with some of Alaska’s most vulnerable people.
Stone said he and his coworkers are passionate about the work they do and most chose it because they want to help people, but the high caseload means that the people they’re representing occasionally fall through the cracks. He said that could mean someone losing housing or benefits, disappearing from an assisted living home or being exploited by a family member.
“When something like that happens, you just feel absolutely sick,” Stone said. “And the only thing you can do is scramble, is to try to correct the issue or intervene in some way, shape or form. If your caseload allows it.”
Stone said he feels overburdened, but he’s not planning to quit. He’s worried about his coworkers though. He sees signs of burnout in almost half of his colleagues.
Guardians haven’t always been so overwhelmed. Last year, when a prominent private guardian gave up his caseload, the system was overburdened and the public office stopped taking new cases. But in December, the state Supreme Court ruled that the state must continue accepting new cases, regardless of caseload. As this crisis unfolds the Office of Public Advocacy’s director, James Stinson, is looking for long-term and short-term solutions.
Stinson thinks the courts need to do a better job of only assigning public guardians for people who have no other option. He’s also looking at longer-term solutions. The office has hired more guardians, but it takes about two years for them to be able to work with a full caseload. And he’s helping facilitate an emerging guardian training program through the University of Alaska. But Stinson said he’s worried that short-term pressures will cause the system to collapse long before those solutions can really change things. He said just one person quitting would have a domino effect.
“What do you do with the other cases?,” Stinson asked. “Well, you have to parse them out to people that already have over 100 cases. And so you just hit a point where it’s just not credible to claim that you’re providing a service.”
Stinson said the court decision mandating the state to keep taking on cases reflects a genuine concern for people who need services, but he thinks the decision puts the whole system at risk. He said guardian programs in other states have the ability to pause assignments.
Stinson also said not everyone who has a guardian needs one and that guardianship should be a last resort.
“This is a stripping away of somebody’s fundamental civil liberties,” Stinson said. “It should be done extremely cautiously, very carefully. There are huge consequences to be(ing) found incapacitated, as an adult human being.”
He said overburdened judges sometimes appoint public guardians even when a family member might be available to do the same work. He said when the state had a waitlist, before the Supreme Court intervened, judges and families got creative to find options that didn’t strip away those civil liberties.
“At first there was the panic of, ‘Who else are we gonna find to be guardian?’” Stinson said. “Slowly, but surely, that evolved into, ‘Well, what other, less restrictive, means are there available?’ which is what you should be doing up front. It’s very hard to incentivize that in a busy overworked system.”
Stone said he estimates about 40% of guardian cases could be taken over by family members or friends. He said often people are afraid to take on the role, but the Office of Public Advocacy offers help for people navigating complex systems of support for their loved ones.
Toward the end of his meeting with Sasha, he asked whether Sasha might want to find other avenues of support.
“If we could reduce the guardianship, would you want to try that?” Stone asked.
“Yeah,” Sasha said. He told Stone he has family in the Mat-Su Borough.
Stinson has been testifying to the Legislature, most recently to a joint House and Senate finance subcommittee. He said he hopes future legislation could help the guardian program become more sustainable and in the meantime, he’ll continue to do the best he can with too many cases for too few guardians.
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Rachel Cassandra covers health and wellness for Alaska Public Media. Reach her at rcassandra@alaskapublic.org. Read more about Rachel here.
